Promoting Awareness Vs. Misleading People About Breast Cancer

Breast cancer is insidious. It’s not necessary to manipulate the truth to convince people that the disease should be eradicated.

Why, then, did its most prominent adversaries feel the need to mislead and deceive in order to promote breast cancer awareness and screening?

According to a story published in the British Medical Journal, (BMJ) Susan G. Komen for the Cure, the world’s largest breast cancer charity, misstated survival differences between women who receive mammograms and those who don’t. In advertising for Breast Cancer Awareness Month in 2011, Komen claimed that almost every breast cancer patient survives five years if her disease is caught early through mammography screening, but that only slightly more than 1 in 5 survive that long if it wasn’t.

But as we have written repeatedly, and as the BMJ researchers said, for most women, promoting routine mammograms ignores “a growing and increasingly accepted body of evidence [showing] that although screening may reduce a woman’s chance of dying from breast cancer by a small amount, it also causes major harms.”

“This benefit of mammography looks so big that it is hard to imagine why anyone would forgo screening. She’d have to be crazy,” wrote Drs. Steven Woloshin and Lisa M. Schwartz of the Dartmouth Institute for Health Policy and Clinical Practice. “But it’s the advertisement that is crazy.”

Woloshin and Schwartz regularly write about exaggerations, distortions and selective reporting, and their broadside against Komen’s tactics was just the latest example of fake statistics used to persuade people to undergo what might well be unnecessary tests.

This year in the U.S. there are 175 officially designated “national health observances,” including rabies day, sleep awareness week and numerous observances for heart disease. Disease awareness is big, and no organization has done more to promote breast cancer awareness than Susan G. Komen for the Cure. It’s the outfit that created the pink ribbon signifier. Last year, we wrote about one of its more curious (some would call it hypocritical) promotions-a pink rifle.

Komen’s efforts “to save lives, empower people, ensure quality care for all and energize science to find the cures,” the writers say, are laudable. But it’s best known for promoting mammography screening. How can such a powerful voice continue to spread misinformation when an increasingly accepted body of evidence shows that although screening may reduce a woman’s chance of dying from breast cancer by a small amount, it also causes major harms?

Woloshin and Schwartz note that the timing of breast cancer diagnosis has little influence on long-term survival; evidence shows that mammography reduces a 50-year-old woman’s risk of dying of breast cancer in 10 years from just over half of 1 percent to just under half of 1 percent.

“Five-year survival is all about what happens from the time of diagnosis,” Woloshin and Schwartz write. “It is the proportion of women who are alive five years after diagnosis. Because screening finds cancers earlier, comparing survival between screened and unscreened women is hopelessly biased.”

This isn’t new; what’s newsworthy is that the organization to whom many people turn for enlightenment and advice about breast cancer is selling, if not snake oil, something just as oily. Komen, the authors say, should be enlightening people not only about the potential benefits of mammography, but the possible risks.

As many as 20 to 50 in 100 women screened annually for a decade will experience at least one “false alarm” that leads to a biopsy. For every life saved by mammography, the procedure overdiagnoses 2 to 10 women. Many of them will undergo unnecessary interventions and treatment.

“Women need much more than marketing slogans about screening,” Woloshin and Schwartz wrote. “They need — and deserve — the facts. The Komen advertisement campaign failed to provide the facts.

“Worse, it undermined decision making by misusing statistics to generate false hope about the benefit of mammography screening. That kind of behavior is not very charitable.”

It’s about as charitable as a life-promoting organization making money by selling death-inducing rifles.

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